Face Transplant Details

Face Transplant Details, The Brigham and Women’s surgeons and others involved in the three full-face transplants performed at the hospital this year have published a detailed account in the New England Journal of Medicine.

The article includes before-and-after photos and explanations of how patients Dallas Wiens, Mitch Hunter, and Charla Nash fared. Although all three had infections and two had episodes of rejection, all were successfully treated.

The lead author is Dr. Bohdan Pomahac, who spearheaded the face transplant program, the second-busiest of its kind in the world. One of the most striking details is about how the faces have changed. Here’s an excerpt:

“We expected major immediate and gradual changes in facial appearance in these patients. We anticipated that the underlying skeleton and facial volume would shape the final facial appearance, making resemblance to the donors unlikely. It is our subjective opinion, as well as that of two of the donor families, that the patients do not look like their donors.

“In conclusion . . . we have shown that it is feasible to perform face transplantation with the use of a consistent, complex protocol. Despite important adverse events and a short follow-up, this study provides further support for the concept that full-face transplantation is able to restore functional defects.’’

Barbara Leadholm will leave her post as commissioner of the Department of Mental Health on Jan. 31 to become a principal in the Boston office of Health Management Associates Inc., a health policy research and consulting firm. She will focus on integrating behavioral health care and substance abuse services into mainstream health care under the federal health law.

She has led the department since 2007. Deputy Commissioner Marcia Fowler will serve as interim commissioner.

Leadholm oversaw the launch of various programs to assist people with serious mental illnesses and provide care in community settings. She oversaw the design of Worcester State Hospital, a 320-bed facility expected to open next year.